Do You Hear What I Hear?

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Early screening for hearing loss is essential for your baby’s health.

Silence isn’t golden for children with hearing loss. That’s why there is a worldwide movement to screen all newborns, now that technology can identify hearing loss in the first few weeks or months of life. Many newborns are screened before they leave the hospital, but not all provinces have newborn hearing testing available in every hospital. In Ontario, screening is well established and shows that approximately four in every 1,000 babies are identified as deaf or hard of hearing.

It is important to know whether your child has a healthy sense of hearing. The first few months of life are important for developing language. Hearing loss that is not detected in these early months is a leading cause in delayed language development.

To keep track of your child’s hearing progress, consider the traits of the following age groups:

From birth to three months, your baby

  • Will look at you during feeding
  • Gets quiet when she hears familiar voices and sounds
  • Is startled by loud noises
  • Makes cooing and gurgling sounds

At three to six months, your baby

  • Will turn her head or eyes toward sound
  • Will respond to you by making noises or waving arms and legs
  • Smiles and laughs
  • Begins to make speech-like sounds

If you think something may be wrong with your baby’s hearing, you can ask your family physician to help find an audiologist with paediatric testing experience. Not all audiologists are set up to test babies, as it takes specialized procedures and equipment. If there’s a children’s hospital in the area, try calling that hospital.

Hearing screenings are painless and very quick, generally taking three to 10 minutes.
There are two types of screening tests used for newborns: automated otoacoustic emissions (OAE) and automated auditory brain stem response (AABR) testing.

Automated (pass/fail) versions are used for screening because the initial screening is often done by a nurse or technician in the hospital rather than by an audiologist. OAE testing involves placing a soft probe in the ear canal. Sound is sent into the ear and a small microphone within the probe measures sounds or emissions coming back out the ear. AABR testing also involves placing a soft probe in the ear to send sound into the ear.

The baby can sleep through the test, which is preferable since testing is easier while the baby is quiet. If a baby doesn’t pass the first hearing screening, it doesn’t mean there’s a problem. Many newborns still have residual birthing debris in the ears (vernix), which can affect the test. If a newborn didn’t pass the first screening, the baby should be re-screened before leaving the hospital or soon afterwards. If the screening is still not a pass, a diagnostic test should be done, preferably before the baby is three months of age.

Only a diagnostic hearing test can confirm hearing loss, including the severity of loss. If a baby is diagnosed with hearing loss, treatment (hearing aids, if appropriate, and early intervention services) should not be delayed.

Children whose hearing loss is treated in the first months of life gain critical time and skills. Studies have shown that children who were diagnosed by six months of age and had early intervention services did significantly better in language and communication skills than children identified later.

According to the Ontario Infant Hearing Program, when babies are identified very early as being deaf or hard of hearing, and given the specialized help they need to develop language, those children can develop language and learn to communicate just as well as hearing children.

Risk Factors for hearing problems

  • Prematurity
  • Low birth weight
  • Craniofacial abnormalities (such as cleft lip/palate)
  • Family history of hearing loss (other than due to old age)

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